Tag Archives: health reform

Health Coverage at Risk for Illinois Children and Families in King v. Burwell

This blog post was coauthored by the Center for Children and Families of the Georgetown University Health Policy Institute.
In the coming weeks, the Supreme Court will rule on King v. Burwell (King), a case that could have far-reaching effects on heal…

Could the U.S. Supreme Court Take Away a Financial Lifeline for Health Care Consumers?

Meet John, a 53-year-old self-employed contractor in Southern Illinois who works construction jobs and earns about $23,000/year. Up until January 2014, when health insurance coverage under the Affordable Care Act (ACA) began, he had never had health in…

The Affordable Care Act Can Reduce Poverty, Just as Medicare Did for Older Adults in the 1960s

As we continue to implement the Affordable Care Act, we should be mindful of the lessons of the War on Poverty and how the creation of programs like Medicare were effective at reducing poverty.
By opening up access to care through the desegregation of …

The Affordable Care Act: Covering More Americans AND Saving Money

You have probably heard a lot of negativity recently about the Affordable Care Act (also known as the ACA or Obamacare). Website glitches, trouble registering, cancelled policies, OH MY!
In this negativity cloud, it’s easy to miss really big, goo…

Happy T-Day

It’s October 1, 2013. Lots going on—or not, since many parts of the federal government are shut down.
But it is a very big day for the 48 million uninsured Americans who need health insurance coverage. It’s opening day for the health …

Consumers Need Protection from Health Insurance Company Plan Year Manipulation

It was disappointing—infuriating actually—to learn that some of the nation’s health insurance companies are trying to take advantage of their current customers by manipulating plan years. They are doing so to avoid having to pass on t…

Illinois Extends Medicaid to Low-Income Adults–a Very Big Deal

Girl at the doctorIllinois took a big step on the road toward all Illinoisans having quality, affordable health care this past week. On July 22, 2013, Illinois Governor Pat Quinn signed into law Senate Bill 26, as Public Act 98-0104. The new law extends Medicaid eligibility to nearly all low-income Illinois residents effective January 1, 2014. Until now, low-income adults, ages 19 through 65, the great majority of whom are working at lower wage/no benefits jobs, have not been eligible for Medicaid. These people qualified only if they were totally disabled or caring for minor children. The federal Affordable Care Act allows states to cover this long left-out group in their Medicaid programs and receive 100% federal funding for the costs. With Public Act 98-0104, Illinois wisely is doing so.   

With the other ACA reforms also set to go into effect January 1, 2014, nearly all uninsured Illinois residents now will have access to public or private health coverage and health care. Those under 138% of the Federal Poverty Level (FPL) ($15,415 for an individual) will be eligible for public coverage in Medicaid. (The income limits are higher for children in Illinois’s All Kids program.) Those over 138% of the FPL will be able to purchase health insurance on the Illinois Health Insurance Marketplace. Illinoisans finally will have peace of mind knowing that:

  • they can get comprehensive, affordable private insurance if their income is over Medicaid’s limits;
  • they can get Medicaid if their income is lower;
  • they can move from public to private health coverage and vice-versa as their income changes; and
  • both the private insurance plans and Medicaid will cover comprehensive, quality care. 

The insurance sold on the Marketplace starting October 1, 2013, will be better in coverage and cost than the individually purchased health insurance now being sold. ACA reforms eliminate insurance companies’ ability to deny or price coverage based on one’s preexisting medical condition or gender. Instead, health insurance policies will be priced on the basis of the customer’s age, geography, number in family, and tobacco usage. Additionally, policies must cover a broad range of needed health services and not charge any copayments or deductibles for preventive care.

Medicaid, too, will offer comprehensive, quality coverage. Skeptics (and there are a lot of them) who disparage Medicaid coverage should take another look. The Illinois Medicaid program has been reforming itself for several years now. It was ahead of the curve on requiring Medicaid patients to have a “medical home,” that is, a primary care doctor who manages their care and refers them for specialty care as needed. It also is testing a variety of “care coordination” models that take the medical home concepts farther and, through provider payment methods aimed at improving quality and decreasing costs, encourage preventive care, discourage unnecessary emergency room use, and support patient follow up and follow through on treatment.

With the enactment of Public Act 98-0104, Illinois is a lot closer to coverage for all. On January 1, 2014 (with enrollment starting October 1, 2013), Illinois residents at all income levels will have access to quality, affordable health insurance coverage. Of course, neither Medicaid coverage nor insurance coverage will drop from the sky. People need to apply. They can do that starting October 1. Between now and then the Illinois government, the federal government, and hundreds of Illinois community groups will be offering information about public and private coverage and the application process. And after October 1, they’ll be there to help us apply and walk us through the enrollment process.  

Unbanked and Uninsured: Implications for ACA Enrollment

As the countdown to full Affordable Care Act insurance coverage on January 1, 2014, proceeds and details get filled in, smart folks in government and the private sector are analyzing those details and catching potential problems. Case in point–a …

Illinois General Assembly Extends Medicaid Coverage to Low-Income Residents

Time: 4:30 p.m Central, Tuesday, May 28, 2013. "Mr. Clerk, take the record." With those words the President of the Illinois Senate asked the clerk of the chamber to record the votes on Senate Bill 26, as amended, the bill which would &nb…

NPR–Addressing the Wrong Question About Disabilities

Several recent NPR stories reported by Chana Joffe-Walt that originated on This American Life perpetuate stereotypes and misconceptions about disability and the country’s main safety net programs that support people with disabilities. Many o…